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    • What is Ear Wax?
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  • What Is Microsuction?
    • What is Ear Wax?
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  • Why Choose DEWAXIFY?
  • Prices
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  • COVID-19 Updates
Micro Suction Ear Wax Removal Consent Form
To safely remove any wax or foreign bodies present within the ear canal, it is important that the clinician is made fully aware of anything which may have a bearing on the procedure. Please answer the following questions regarding your hearing health by ticking and completing the relevant boxes:
If you begin to feel even the the slightest bit dizzy or faint during the procedure it is important that you let the clinician know at the very first sign.
(Years, months)
(E.g. Warfarin)
Please discuss this with your clinician before signing this form.
(or signature of a parent if under 16, guardian or attorney if appropriate)
This form is completed to the best of my knowledge.

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  • 0800 009 6331
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  • What Is Microsuction?
    • What is Ear Wax?
  • Book an Appointment
  • Why Choose DEWAXIFY?
  • Prices
  • Consent Form
  • Blog
  • COVID-19 Updates
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